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Just a question

Warrior4104 profile image
22 Replies

Do bronchs always have to take antibiotics for an infection? Or should they wait for their situation to go down or making them poorly?

I have a slight change in my sputum color to dark, but dont have a fever and I don’t want to take any antibiotics as it is already too much for me since last 3-4 months. What’d y’all suggest?

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Warrior4104
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22 Replies
teddyd profile image
teddyd

I certainly always take antibiotics for infections.

A simple change of colour does not necessarily indicate an exacerbation. Mine changes in colour during the day. Darker in the morning and light by evening. Similarly, it is possible to have an exacerbation without a temp. We all go through the time when we are wondering if it is an exacerbation or not. If you get more and more mucus, it thickens up and the colour is consistently darker, that is more likely than not, an exacerbation and will need 2 weeks abs.Otherwise keep an eye on it and be guided by how you feel.

Do remember to work very hard at clearing your lungs several times each day. This helps to prevent the bacteria from breeding in the warm wet stuff in your lungs.

Warrior4104 profile image
Warrior4104 in reply to

sputum isnt thick maybe because I’m nebulizing with saline, but the color is consistently dark. I have an exacerbation every month! What should I do? Do I have to ask for consistent antibiotic?

in reply to Warrior4104

I'm not at all sure that you are actually having a proper exacerbation every month but rather that you are far too preoccupied with the every day state of your bronchiectasis and are misinterpreting every day changes as an exacerbation..The mucus can vary in colour without there being an exacerbation and as you say that it is runny, then you should be working very hard to clear it from your lungs. You need to develop a routine for this. Do it and then get on with your day.This is life with bronch. It is far more about self management than taking non stop antibiotics.If indeed you are having an exacerbation every month the treatment that you are getting is woefully inadequate. Either the wrong antibiotic or not a high enough dose. If, as you say, your consultant is a true bronch specialist you need to talk to them so that they can tell you from your own particular symptoms whether you are having an exacerbation or whether this is the normal day to day life with your particular bronch. Basically, if you don't feel poorly it is not an exacerbation in my experience but you need the advice of your consultant on this.

Warrior4104 profile image
Warrior4104 in reply to

i won’t blame my doctor for this situation as both of us were confused.

I have had 3 sputum cultures uptill now. The first one said pseudomonas after which I was treated with IV+ oral antibiotics for 14 days.

After a month I developed a fever again and this culture didn’t show pseudomonas but some fungi which was treated by itraconazole. My doc said that in bronch we try to treat pseudomonas in the first isolate i.e the first time it is identified and sometimes it is eradicated from the body, but there are some patients who are colonized lifetime with pseudomonas and require antibiotics for every exacerbation.

As my second culture didn’t show pseudomonas, we assumed that it was gone.

After that for every infection I was being treated with levofloxacin (to which I am resistant as per the new culture reports). I got better for a month, then ill again.

15-20 days ago I had my culture again, it showed pseudomonas and staph aureus. I wasn’t ill at that time nor I had any symptoms that bothered me. But I still contacted the hospital and doctor said if I feel I am okay I dont need antibiotics.

I did so, I didn’t take any antibiotics but my regular inhalers etc for asthma and lung clearance daily until my little sister developed a chest infection and Again, I woke up with a green sputum.

I am considering to go to the doctor. Maybe in 2-3 days, let’s see what happens

in reply to Warrior4104

just to say, my tests always show pseudomonas but I have only had to have one session of oral cipro in 12 months. It is possible that your sister’s virus has been passed to you. All of my exacerbations come off the back of virus infections. They create the environment for opportunistic bacteria to breed. Do discuss it with your doctor but believe me, how you feel, together with the amount, colour and texture of your sputum is far more important than unreliable lab plates. When you have an exacerbation the mucus will thicken up even if you are nebulising saline.

Warrior4104 profile image
Warrior4104 in reply to

I will discuss with the doctor tomorrow. Thankyou very much for your help littlepom.

Patk1 profile image
Patk1 in reply to Warrior4104

Put a sample in for testing

B0xermad profile image
B0xermad

I would send a sputum sample to be analysed to see if infection is present via gp if you are unsure about taking more antibiotics

Lutontown profile image
Lutontown

How do you feel? I always knew when it was time to act. Put in a sputum sample to your surgery for testing. Then if a bug is present the medics will suggest if and what antibiotic is necessary, or if at all. Can take up to 10 days. I've had bugs in sputum that is white, so you never know.

Warrior4104 profile image
Warrior4104 in reply to Lutontown

I had my sputum checked about 15 days ago, the culture showed I had pseudomonas as I am colonized with it. I contacted my doctor he said I don’t need antibiotics as I was feeling very well. At that time the color of my sputum wasn’t that dark.

Now it is really dark and runny that I get short of breath very easily despite of taking my inhalers etc. This is why I fear I might have an exacerbation again. Otherwise I am okay. I dont have any fever or that lots of sputum.

Lutontown profile image
Lutontown in reply to Warrior4104

I used to have many chest infections, loads in 2016, so kept a diary in 2017 when I counted 18 chest infections. In March 2018 had our bath changed for a walk-in shower, and the bathroom floor was found to be covered in black mould. Due to leaking of the bath drain. The floor was replaced thereby eradicating the mould. Since then, other than a stay in hospital with pneumonia and pleurisy, I have had no chest infections. Worth checking your home for mould.

Warrior4104 profile image
Warrior4104 in reply to Lutontown

I have a question, when you had the infections, did your sputum give a greyish or black tinge? If the mold was to blamed, I think this tinge that I have was due to it maybe? I live near the countryside and have lots of greenery near me. Could this be the reason?

Lutontown profile image
Lutontown in reply to Warrior4104

As I said I've had numerous chest infections over the years, and sputum has been various colours. White, creamy, green, speckled, brown. A selection of bugs, and antibiotics:- amoxacillin, ciprofloxacin, oxytetracycline, doxycycline, co-amoxyclav, levofloxacin, co-trimoxazole, and with steroids sometimes. Had to have IV AB's in 2014 when I had staphylloccus aureus bug for ages. I think this bug caused my bi-basal bronchiectasis. But as I've said, no chest infections since March 2018, with no mould in home.

Patk1 profile image
Patk1 in reply to Warrior4104

Do u do dedicated lung clearance sessions x

Timberman profile image
Timberman

In the UK we are advised not to take a third dose of antibiotics in a year without medical advice. So I would seek advice.

However dark sputum is a good sign of an infection and not having a temperature only indicates that as yet your system is not working overtime to handle the infection - but it could change rapidly.

How is your breathing? If it is worse than usual then you are clearly suffering an infection of some sort. However it may not be in the respiratory area so again, seek advice. A blood test will confirm, via the creatinine levels.

Warrior4104 profile image
Warrior4104 in reply to Timberman

I am having breathing issues. But I might blame it due to a cold weather as cold has always aggravated my asthma symptoms. Ugh im so confused what is even happening

Timberman profile image
Timberman in reply to Warrior4104

Sounds as if you live in a fairly clean air environment. Do you have a COPD specialist nurse available to talk to? They are much better than ordinary GPs as they have specialist training and skills.

Warrior4104 profile image
Warrior4104 in reply to Timberman

Unfortunately I don’t have any of these services available. I will surely visit my doc tomorrow.

Patk1 profile image
Patk1 in reply to Warrior4104

I find if it's inflammatory,without infection, additional pufferz+ nebs and steroids help. It took time to learn to separate inflammation/infection and sometimes it's both! X

Patk1 profile image
Patk1 in reply to Warrior4104

It would probably be benefici am to u,to ask gp to refer you to pulmonary rehab which consists of exercise & education on managing conditions,how to recognise flare ups,infections etc.its worth putting specimen in few days after completing antibiotics to see if it's cleared it.sometimes with bronchiectasis,we need extended courses x

Timberman profile image
Timberman

And in the UK we always have a sputum test jar available to send off for testing - can you get one?

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